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"Snuffy" Myers checks in on the USPSTF recommendation to end screening for prostate cancer

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Posted 10/19/2011 5:51 PM (GMT 0)
I will have two very excellent prostate cancer oncologists on tomorrow nights UsTOO meeting and they share the same point of view as this man. Dr. Charles "Snuffy" Myers released a video today on his take on the USPSTF draft recommendation to stamp out PSA screening for prostate cancer. Here ya go:

askdrmyers.wordpress.com/2011/10/19/prostate-cancer-screening/

My own oncologist, Dr. Nicholas Vogelzang, has spoken many times at our UsTOO group and has the same position that Myers has ~ prostate cancer is two diseases. One that will never hurt you, and one that is as aggressive as most cancers. One that may never need treatment and one that needs early treatment to find a cure.

Have a look...

Tony
Posted 10/19/2011 6:44 PM (GMT 0)
Really liked what he was saying until he started to run parallels with Vietnam. He kind of took of on a rant that could be deconstructed in many different ways.
Posted 10/19/2011 7:09 PM (GMT 0)
I listened to Snuffy earlier today.

He is very passionate that is for sure!

As mentioned in other posts - Screen Everyone! Than lets have the medical community be wise on what the next steps are.
Posted 10/19/2011 7:24 PM (GMT 0)
His statement that prostate cancer deaths could quickly be reduced from 30,000 to 3,000 was startling. 

I also don't dispute his feelings that old men don't get a lot of respect in 21st century America, but I'm not sure if the Vietnam tie-in was pertinent.  Every generation (or at least almost every generation) sacrifices, and ours certainly did, but we also helped reinforce the emphasis on youthfulness that continues today, so maybe it's a wash.

Wouldn't it be great, though, if we could see the dramatic reduction in PCa deaths that he claims is possible?

Posted 10/19/2011 7:27 PM (GMT 0)
Brings back memories of all the bruha that stirred up here when the Australian doctor posted the link for his book (Sleeping Dogs ...).

The information was great, but the message and motivation was suspect to some. At least here there is no question what they are trying to say.

The biggest issue I see is not the scope of testing, but having the ability to use the best test and read the results. It is that second part that we don't have a grip on. If someone gets the test right, it should become universal. Until then ....

Posted 10/19/2011 9:14 PM (GMT 0)
His political ramblings, to me, took away anything good he said about the main topic, screening. This guy is way outside the loop in my opinion, and it makes me understand why I haven't met a doctor yet, that knows him and his work, that puts much stock in his opinions. He won't be making any money off of me. Not a popular opinion, I am certain, as some idolize him, but just my personal take.

david in sc
Posted 10/19/2011 11:09 PM (GMT 0)

Myers is my medical oncologist I'm somewhat surprised that he displayed his politics and life philosophy on his patient pulpit, but if you meet him you understand his passion. My extremely aggressive PCa is partially fueled by my agent orange exposure so I am in agreement with Snuffy Myers on several levels. His standard of care approaches are individualized and off the beaten path but his track record is the reason for his huge audience. He truly beats the odds. I"m at the scary part of this disease but I feel very comfortable in his care. Best wishes to all my brothers on this tumultuous journey.

Jim

Posted 10/20/2011 12:41 AM (GMT 0)
His Political views aside, what he had to say makes a lot of sense.

I like the way that he is not frightened to speak his mind. And isn't it always the way, in his profession, that what he speaks of will be scorned by many and loved by a few?

It reminds me of the late great American Golfer, Moe Norman. Who was unconventional, did things golf-wise, in his own way and bucked the trend. He was not liked in many quarters, but truly a great golfer.

Chris.
Posted 10/20/2011 1:11 AM (GMT 0)
Dr Myers is also my medical oncologist. His knowledge and passion in fighting this desease is very comforting. His methods may not be main stream, but if you have advanced aggressive PCa many men want to do everything they can to slow down the progression of the desease. He may not be held in high regard by some doctors in Noth Carolina, but his national and international reputation is strong.
Posted 10/20/2011 1:20 AM (GMT 0)
If I'm understanding him right, he seems to be saying that people such as myself, with low grade prostate cancer (Gleason 6, low PSA) should defer treatment. It goes against what my urologist is telling me as he recommends immediate treatment for someone my age. I'm going for a second opinion at the end of the month so it will be interesting to see what that urologist says. It's hard for a patient to make a decision with such contradictory points of view. However, I will say that I generally get a sense that this Dr. Myers is a "straight shooter". But then again my urologist seems to be a pretty straight shooter as well. Regardless of the amount of research I do, this decision just doesn't get any easier.
Posted 10/20/2011 1:56 AM (GMT 0)
Tony, Thanks for the post. He made the point that we may not be able to tell which PCa is going to be a sleeper but we sure know when it is beast. That squares with what I read on the task force recommendation. He also notes that most docs will recommend the surgery even if it is low risk. I think most patients would demand it too once they hear "cancer". Also given the propensity for law suits in our society I can not blame a doctor for taking the "safe" recommendation. Personally, I do not see the problem as screen or not screen but rather treat right away or monitor. Tough decision for the patient and the doctor with limited information to go on.

Don
Posted 10/20/2011 2:41 AM (GMT 0)

Dr Myers is one of the true gurus treating advanced prostate cancer, and is globally respected by knowledgeable doctors in the PC treatment field.

don826 said...
He made the point that we may not be able to tell which PCa is going to be a sleeper...

Actually, Don, I thought Dr Myers made his point quite clear when he just about came out of his chair and said "bull ****" to the notion that we can't tell indolent tumors.  While he stressed that it's not perfect, the AUA guidelines do a very good job of "identifying the relative risk."  Re-check at about the 6:50 mark... 


Posted 10/20/2011 2:53 AM (GMT 0)
Dreamerboy,
Try getting that second opinion from a medical oncologist instead of another urologist. Urologists operate. RO's radiate. I believe that good oncologists do a better job of assessing risk.

Another good step for you before treatment is to get the biopsy slides sent out for a second opinion. Pathologists make mistakes too even though it's rare. But they could upgrade the disease requiring treatment as well...


Tony
Posted 10/20/2011 3:02 AM (GMT 0)

anfidelmar said...
His Political views aside, what he had to say makes a lot of sense.

I like the way that he is not frightened to speak his mind. And isn't it always the way, in his profession, that what he speaks of will be scorned by many and loved by a few?

It reminds me of the late great American Golfer, Moe Norman. Who was unconventional, did things golf-wise, in his own way and bucked the trend. He was not liked in many quarters, but truly a great golfer.

Chris.

Moe Norman was not American, he was Canadian- also not so much that he bucked the system- he was autistic and looked upon as an oddball - his lack of social skills held him back.

But you are correct in describing him as a great golfer- Tiger describes Moe Norman and Ben Hogan as the two best ball srtikers of all-time.

As far as Myers goes, brother Oncas supports him and thats good enough for me.
Posted 10/20/2011 7:10 AM (GMT 0)
Interesting video.
A pity he didn't split it into two separate videos, one to cover his opinion about the Task Force's recommendation, which I guess a lot of us can agree with, and another separate one to cover his (political) views about Vietnam, old men, corruption etc, which may be at odds with our own thoughts on the subject. (This rant of his should help guys understand the forum has rules about leaving politics out of our discussions.)

Dreamerboy - You could be a borderline case, but I kind of agree with Tony that a second reading would help. And as your PSA has actually gone down, I'd say it might be okay to hold off a decision till you have another PSA test a couple of months after the last one.

Alf
Posted 10/20/2011 11:27 AM (GMT 0)
Thanks very much for the advice from Alf and Tony. I am also getting a booking with a medical oncologist, aside from the second opinion from another urologist. I already had one appointment with a medical oncologist but I didn't consider that a valid second opinion as he would only give me 5 minutes of his time and wouldn't allow me time to ask questions. Regarding the slides, in Canada, or at least in this jurisdiction, my slides are automatically sent to another pathologist for a second opinion. However, this is someone in the same hospital and I'm not sure if he's aware of the diagnosis from the first pathologist. My doctors assure me that there is no real room for error. But perhaps I should ask a few more questions.
Posted 10/20/2011 6:30 PM (GMT 0)
D-boy:
I am convinced that many men with disease that is small volume, slow growing, such as yours, can see psa differences with reasonable supplement use, mild prescription drugs (celebrex, statins, etc.), and significant diet changes (super low fat). That said, we know that changes in psa do not mean changes in tumor aggression.
I do believe that those men who adopt such measures and then see a psa lowering, have truly tested their tumor and shown it to be less lethal than if such measures had been followed by no change or an increasing psa. Your trial (of one) demonstrates that your tumor is responsive to indirect vectors. This is another kind of informal proof that you may follow AS for as long as the psa/biopsy/symptom/mental strength factors allow.

JohnC
Posted 10/27/2011 10:48 AM (GMT 0)
Living in toronto and in the same quandary as Dreamer boy I was inspired by reading The invasion of the Prostate Snatchers to seek Medical Oncologist advice as they only deal with prostate cancer -unlike urologists and radiation oncologists. Toronto also has an excellent Man to Man group

My canadian doctors at Princess margerat Hospital all recommended surgery and Dr. Myers and Dr. Bahn recommended radiation as my lesion was mostly in apex so there was a greater risk of Urinary and ED problems.

In the end I decided to go Germany for Hyperthermia, and 6 months of Hormone therapy

This procedure has a high success rate, very low risk of side effects and still allow me to do surgery or radiation if unsuccessful

age 60 PSA 4.9 Gleason 7 (3+4 ) second biopsy 6 months later Gleason 6 ( 3+3 )

Probably Dr. Klotz at Sunnybrook would be a very good second opinion and at gleason 6 might put you on active surveillance

Do not minimize value of supplements as Vit D3, Resveratrol, Curcumin and Lycopene in slowing Pca
some doctors would also put you on Avodart as well
Posted 10/27/2011 5:30 PM (GMT 0)

Dreamerboy said...
If I'm understanding him right, he seems to be saying that people such as myself, with low grade prostate cancer (Gleason 6, low PSA) should defer treatment. It goes against what my urologist is telling me as he recommends immediate treatment for someone my age. I'm going for a second opinion at the end of the month so it will be interesting to see what that urologist says. It's hard for a patient to make a decision with such contradictory points of view. However, I will say that I generally get a sense that this Dr. Myers is a "straight shooter". But then again my urologist seems to be a pretty straight shooter as well. Regardless of the amount of research I do, this decision just doesn't get any easier.

 

He said from what I understood that it most likely would be harmless garden varity PC but you can't be sure it could be the agressive type. I don't know what I would do in this sistuation.

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